Intensive Robot-Assisted Gait Training in Individuals with Chronic Spinal Cord Injury: Case Series from Saudi Arabia

Abstract

Purpose: The aim of this study was to report whether intensive body weight-supported treadmill training with a robotic exoskeleton could improve over-ground functional mobility in individuals with chronic spinal cord injury and to investigate its feasibility and safety. Methods: This was a case series design. Two male individuals with chronic (> 1 year since injury) spinal cord injury (SCI) were included in this study. All subjects underwent intensive gait training sessions 5 times per week using exoskeleton for 12 weeks with a total of 60 sessions. The duration of the session was 60 minutes, including the installment of the HAL, gait training, and the removal of the HAL. The training was performed on a treadmill with adjustable speed and a lifter, under the supervision of a physiotherapist. Two types of outcomes were collected: treadmill-associated data and functional outcomes. Results: We observed a continuous increase in treadmill walking distance, time, and speed for both cases from baseline assessment until the end of the study at 12 weeks The findings from this study provide evidence that the Hybrid Assistive Limb (HAL) can be used with chronic spinal cord injury and can improve walking abilities in terms of distance, speed, and time. Conclusion: HAL can be used for gait training in rehabilitation facilities for individuals with chronic spinal cord injury and did not cause any serious adverse effects to the participating subjects. Our results support the findings of previous studies that show that treatment with HAL may result in improvement in gait parameters. However, more studies with a larger sample size are needed to compare the effect of HAL with conventional physical therapy